“That’s the vendor’s problem.”
On several occasions, I’ve heard this sentence, or one like it, when talking with providers and health plans about their strategies to meet the interoperability and information blocking imperatives. In an information sharing economy, however, this assumption is very risky as it assumes everything is technological. It's not. Process and education are also major components of successful interoperability.
Information sharing is a cross enterprise process that requires organizations attend to the connections between them at least as much as they prepare their internal systems and workflows. Assembling and refining these internal systems and workflows does little, if anything, to prepare organizations to interact with third parties that participate in the end-to-end data sharing process, engage members and patients to access and use their data, enroll exchange partners in an orderly and efficient manner, and respond to disruptions in information flow that occur outside their four walls.
Information sharing is a means to multiple ends. Achieving the requisite technical capability may demonstrate compliance with regulations in a minimum necessary fashion but the name of the game is value-based care. Combining clinical and administrative data enables better contracts, improved and less costly healthcare for patients and members, and a greatly simplified health care experience for the consumer.
Information sharing requires standardizing data and putting it in the right place. Few healthcare organizations are prepared to share information, despite their investments in new technologies and consulting services to implement them. Clinical data must conform to specific vocabularies (SNOMED, LOINC, RxNorm, and others) before it can be shared. The billing diagnostic and procedure codes (ICD-10 and CPT) are used occasionally, but sparingly. These correct clinical codes must also be placed in the fields where they can be found in the electronic health record and not buried in free text fields and notes.
At MHDC, we are working with members of our Data Governance Collaborative and educating our community in the importance of attending to these essential elements of information sharing that fall outside the organization’s direct control. While some health plans and providers have the deep pockets to invest in new technologies and services that improve their internal information management, others do not. Those organizations that take a holistic view of information sharing may spend a good deal less and be further ahead in the months and years to come.
Denny Brennan, Executive Director
Please let us know what you think of our newsletter at newsletter@mahealthdata.org and look for our next issue. Thank you for your continued support and participation!
MHDC EventsMeetings this month:
Want to learn more about any of these meetings? Email info@mahealthdata.org |
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MHDC WebinarsJoin us for exclusive interviews with some of healthcare’s most recognized leaders as they reveal how and why they chose their careers, what they learned on their journey, and how to apply these insights to the everchanging future of healthcare. Our next Vantage Point Series interview features Alexandra Drane on October 5th from noon-1pm. Missed our previous Vantage Point Series interviews? You can find recordings here. |
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The Vantage Point Series Join us for exclusive interviews with some of healthcare’s most recognized leaders as they reveal how and why they chose their careers, what they learned on their journey, and how to apply these insights to the everchanging future of healthcare. Our next Vantage Point Series interview features Alexandra Drane on October 5th from noon-1pm. Missed our previous Vantage Point Series interviews? You can find recordings here. |
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NEHEN Update
Electronic Prior Authorization InitiativeThis project is a prototype implementation that automates prior authorization transactions using the industry standard, open platform methods developed by the HL7 DaVinci Prior Authorization workgroup. This project will be compliant with the three related implementation guides which utilize open, FHIR based API exchange methods. This will allow each payer and each provider to implement a single prior authorization process and format for exchange so long as all of their exchange partners adhere to the same standards. Although the progress on this initiative has been slower than initially anticipated, we are close to having signed participation agreements with the participants. Once this happens we should be able to move more quickly going forward. As this process has moved foward we have continued our participation in the DaVinci Prior Authorization workgroup activities including assisting with the creation and refinement of the evolving standards and methods for ePA and development of a new version of the implementation guide planned for 2022 to ensure we retain alignment with industry standards. CMS has not provided updates on the release of the Burden Reduction Prior Authorization rules (which match the process used by this project as well as providing updates to other interoperability requirements). We hope that a new proposed final rule will be released by the end of this year but that is not clear at this point. Watch this space for more information. For more information email us at epa@mahealthdata.org. |
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Industry Events |
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What is a Social Determinant of Health?
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Hispanic Heritage MonthSeptember 15th to October 15 is National Hispanic Heritage Month which celebrates and honors the many cultural contributions and achievements of Hispanics and Latino Americans. What originally began as Hispanic Heritage Week back in 1968 under President Lyndon Johnson was expanded to a month two decades later by President Reagan. There are many ways to celebrate; here are a few links to get you started:
You can also find more on social media using #HispanicHeritageMonth |
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Wrapping UpBefore we go, here's a reminder of upcoming data exchange deadlines from ONC and CMS (including the CMS rule that's currently frozen, as noted by *):And that's it, folks. Loved it? Hated it? Have an idea for next time? Send us feedback and suggestions about this newsletter at newsletter@mahealthdata.org or send us feedback and suggestions about anything else at info@mahealthdata.org.
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